Detecting fetal compromise during active labour and managing neonatal after-effects.

Evaluating fetal wellbeing during the intrapartum period to detect fetal compromise and hypoxia is a topic of considerable importance to midwives. In part this is because the events during this time can have profound significance for the physical and emotional wellbeing of all those involved, including the infant, mother and midwife. This article explores the ways midwives can detect fetal compromise, what they can do to limit the effects of cerebral hypoxic-ischaemia, and reviews neonatal treatments that,can optimise infant neurological outcome.

The road to life. Neonatal transitions to extra-uterine life.

The onset of labour and birth initiates profound changes for infants. It is essential to understand these unique aspects of childbirth; doing so will equip midwives with the ability to detect deviations from expected trajectories, take appropriate actions, but most importantly support normal birth transitions. These transitions involve a complex cascade of physiological, anatomical and behavioural changes acting in concert. This article overviews essential knowledge about the early adaptive changes after birth and considers initial cardio-respiratory and metabolic responses to birth, together with how midwives can support the best possible start for infants.